Waiting List Submission

First Name *

Surname *

Date of Birth

Address, including postcode *

Contact Number *

Type of animal you wish to surrender.(If Guinea pig, please select 'Rabbit' as we use the same waiting list for both of these animals). *

How many animals do you need to surrender? If multiple animals, are they able to share an enclosure? Please include names, ages, genders. *

Castrated / Spayed? *

Vaccinated? *

Do you have the vaccination card provided when the animal was vaccinated? If so, please ensure you bring this with you on the day of surrender. *

Name and address of vets registered with, and details of who neutered/vaccinated the animal if different to current vets. *

Microchipped? *

Microchip Number

Reason for surrender *

Is there any other information you wish to provide us? Please note- we are unable to prioritise based on things like moving out dates etc, we will prioritise based on need, if all need levels are the same, then we will work through the list chronologically.

I agree that all information provided above is correct and true to the best of my knowledge. I can provide current ID upon request when I surrender my animal. *